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Related Experiment Video

Updated: Sep 13, 2025

A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
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Optimizing Prostate Cancer Care: Clinical Utility of the Prostate Health Index.

I-Ta Lee1, Chun-Ming Hou2,3, Thi Thuy Tien Vo4

  • 1School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.

The Prostate
|August 1, 2025
PubMed
Summary

The Prostate Health Index (PHI) improves prostate cancer detection and risk stratification over traditional PSA tests. This biomarker helps reduce unnecessary biopsies and identify significant cancers more accurately.

Keywords:
active surveillanceclinically significant prostate cancerprostate health indexprostate‐specific antigenradical prostatectomy

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Area of Science:

  • Urology
  • Oncology
  • Biomarker Research

Background:

  • Prostate cancer (PCa) diagnosis relies on methods like DRE and PSA, which have limitations in specificity, leading to overdiagnosis.
  • The Prostate Health Index (PHI), a combination of PSA, free PSA, and [-2]proPSA, offers improved PCa detection and risk assessment.

Purpose of the Study:

  • To review the diagnostic and prognostic performance of PHI in prostate cancer.
  • To evaluate PHI's utility in various clinical settings, including initial and repeat biopsies, and its integration with other diagnostic tools.

Main Methods:

  • Narrative review of clinical trials and meta-analyses on PHI's performance.
  • Analysis of studies focusing on PHI's use in different biopsy scenarios, ethnic variations, and combination with multiparametric MRI (mpMRI).

Main Results:

  • PHI shows superior accuracy to PSA alone, especially in the 2-10 ng/mL range, reducing unnecessary biopsies and improving detection of significant PCa.
  • PHI provides added value with mpMRI and risk stratification, with ethnic variations noted.
  • PHI is relevant for predicting Gleason score upgrades and active surveillance reclassification.

Conclusions:

  • PHI is a valuable noninvasive tool for enhancing PCa diagnostic precision and aiding treatment decisions, potentially reducing overtreatment.
  • Integration of PHI into clinical practice can optimize PCa management, though standardized thresholds and multiparametric integration require further research.